Rationing of nursing care in Internal Medicine Departments—a cross-sectional study

Abstract

Background: Implicit rationing of nursing care refers to a situation in which necessary nursing care is not performed to meet all of the patients’ needs. Purpose: To examine the factors influencing the rationing of nursing care, nurses’ assessment of the quality of patient care, and their job satisfaction in Internal Medicine Departments. Methods: A cross-sectional descriptive study was undertaken. The study included 1164 nurses working in the Internal Medicine Departments in 8 hospitals (Lower Silesia, Poland). The Perceived Implicit Rationing of Nursing Care instrument was used. Results: Respondents rarely ration nursing care, with a mean score of 1.12 (SD = 0.68). The mean score for quality of patient care was 6.99 (SD = 1.92). In contrast, the mean job satisfaction score was 6.07 points (SD = 2.22). The most important predictors of high rates of rationing of nursing care were work experience of 16–20 years (regression parameter: 0.387) and a Bachelor’s degree in nursing (regression parameter: 0.139). Nurses’ assessment of the quality of patient care ratings were increased by having a Master’s degree in nursing (regression parameter: 0.41), and significantly decreased by work experience of 16–20 years (regression parameter: -1.332). Independent predictors of job satisfaction ratings in both univariate and multivariate analysis were Master’s degree and long-shift working patterns. Conclusion: The factors that influence an increased level of nursing care rationing on medical wards are nurse seniority, exceeding 16 years and female gender. Obtaining a Master’s degree in nursing indicates improved nurses’ assessment of the quality of patient care.